Document Detail

Tight control early rheumatoid arthritis clinic in Hong Kong: a pilot study.
MedLine Citation:
PMID:  22477733     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE. To evaluate disease activity in early rheumatoid arthritis patients in daily practice 1 year after applying a tight control treatment strategy aimed at lowering disease activity (Disease Activity Score 28, ≤3.2). DESIGN. Single-arm open trial with historical controls. SETTING. Regional hospital, Hong Kong. PATIENTS. All new rheumatoid arthritis patients (onset <2 years) attending the tight control clinic from October 2008 to October 2009 were recruited. All the patients were followed up every 3 to 6 weeks and clinically assessed using the Disease Activity Score 28. Disease-modifying agent treatment was stepped up according to a preset protocol ladder and patient tolerance. The treatment target was to achieve a Disease Activity Score 28 of 3.2 or below (low disease activity). These patients were compared to matched historical controls in the rheumatology clinic. RESULTS. Twenty patients in the tight control early rheumatoid arthritis clinic were recruited. Their disease activities were brought into better control than historical control patients who were followed up every 12 weeks. At week 52, clinical variables showed greater improvements in the intensive care group; respective mean scores (based on the Disease Activity Score 28 system) were 2.7 versus 4.2 (P<0.001); respective mean Health Assessment Questionnaire scores were 0.2 versus 1.3 (P<0.001). CONCLUSION. Outcomes of patients attending our locally adapted tight control clinic were consistent with previous reports in the literature. The clinic reduced rheumatoid arthritis activity faster and better. It entailed more frequent follow-up and monitoring, however. To address this strategy more objectively, a randomised trial with parallel controls is necessary.
K Y Kwok; M H Leung
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine     Volume:  18     ISSN:  1024-2708     ISO Abbreviation:  Hong Kong Med J     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512509     Medline TA:  Hong Kong Med J     Country:  China    
Other Details:
Languages:  eng     Pagination:  108-14     Citation Subset:  IM    
Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
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